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States in the Middle East and North Africa (MENA) have historically leaned towards conservative, reactionary models of drugs policy. The combination of authoritarian forms of government, whether dynastic monarchies (Morocco, Jordan and Persian Gulf countries), semi-military republics (Syria, Egypt and Algeria) or religiously sanctioned republics (Iran), with the strong influence of Islamic law and norms, has signified that the region has enforced strict forms of drug prohibitions. For that matter, the region is home to cultural and social norms that are less permissive than in other regions of the world: for instance, with regard to premarital sex, homosexuality, clothing, alcoholic drinks and freedom of expression. This image of the MENA region is often overplayed by media commentators and Western scholars, especially in the field of drugs policy. The almost total absence of studies of drugs policy or drugs history in the MENA, excluding works in epidemiology, speaks well about the oblivion to which the region has been relegated over the last decades. The chapter provides first a background on the main questions regarding MENA drugs policy, looking at the historical developments in drug regulations and drug trends. Then, it discusses the current policies that operate across the region and, if pertinent, the prospects of policy development. When necessary, the argument refers to contextual elements that have influenced the direction in national and transitional drugs policy. Conscious of the fact that the MENA is as vast and diverse as a continent, I have opted to focus on three paradigmatic cases (Iran, Lebanon and Saudi Arabia), which provide an adequate geographical and thematic coverage of the MENA drugs policy. The three cases cover different aspects of today’s MENA drugs policy spectrum, from draconian repressive measures to progressive harm reduction programmes. Taken in their geographical dimension one can appreciate the variety and difference that exists within the MENA region, therefore supporting one of the key objectives of this chapter, which is to provide a nuanced analysis of drugs policy against the grain of homogenising and culturally reductive approaches.

Human performance, particularly that of the warfighter, has been the subject of a large amount of research during the past few decades. For example, in the Medline database of medical and psychological research, 1,061 papers had been published on the topic of “military performance” as of October 2003. Because warfighters are often pushed to physiological and mental extremes, a study of their performance provides a unique glimpse of the interplay of a wide variety of intrinsic and extrinsic factors on the functioning of the human brain and body. Unfortunately, it has proven very difficult to build performance models that can adequately incorporate the myriad of physiological, medical, social, and cognitive factors that influence behavior in extreme conditions. The chief purpose of this chapter is to provide a neurobiological (neurochemical) framework for building and integrating warfighter performance models in the physiological, medical, social, and cognitive areas. This framework should be relevant to all other professionals who routinely operate in extreme environments. The secondary purpose of this chapter is to recommend various performance metrics that can be linked to specific neurochemical states and can accordingly strengthen and extend the scope of the neurochemical model.

Despite the increasing evidence on the effects of the economic crisis and austerity policies on the health of the population, we lack knowledge of how the young population is being affected. High unemployment rates, labour instability, high housing costs and cuts in public policies have placed the young in a vulnerable situation. We explore changes (2006–2017) in the both physical and mental health of young people in Spain using a selection of health indicators. By doing so we draw the reader’s attention to three elements with a close relationship to neoliberalism: the prominence of social determinants of health, the importance of inequalities and the accumulation of multiple sources of disadvantage in certain groups and individuals which ultimately condition the course of their lives; and the use of medicalization as a common and legitimised response to poor mental health.

The Reformation, as Wolfgang Schivelbusch maintains, which redefined the relationship between the individual and God as a personal one, “took pains to regulate the relationship of man to alcohol,” and in so doing laid “an essential foundation¦…¦for the development of capitalism.” In the earlier Rabelaisian world, the Church constituted the major site of popular culture. Virtually all work was seasonal in character punctuated by carnivalesque church feasts that numbered over one hundred yearly. Although generally accepted as a safe means to vent communal anxieties, drink comprised an essential element of these festivals, with drunkenness the socially acceptable outcome.¹⁶ However, as the Reformation progressed and new modes of aristocratic behavior developed, reformative efforts to separate the secular and the sacred within the church resulted in attempts to abandon the popular culture of the lower classes. A broad consensus emerged that too much drunkenness amounted to social evil, and that alehouses represented an “increasingly dangerous force in popular society.”¹⁷ As the influence of the Church declined in the early eighteenth century, Carnival resurfaced in the form of gregarious carnivalesque village and town feasts: “the grotesque body of carnival was being re-territorialized” and writers such as Swift and Pope “perpetually identif[ied] the scene of writing with the fairground and the carnival.”¹⁸ Conversely, in keeping with the symmetrical component inherent in the Carnival/Lent theme, Lent transmuted into organizations such as The Society for the Reformation of Manners, which attempted to reduce drunkenness, cursing, swearing and whoring – all tropes of carnivalesque gregariousness. So, during this period, a contradictory cultural dissonance was being enacted. On the one hand, we find a resurgence of Carnival, but on the other hand, we see “a conservative desire on the part of the upper classes to separate themselves more clearly and distinctly from these popular activities.”¹⁹

Recreational drug use is widespread. It is argued that it has reached a phase of ‘normalisation’ among youth and has become a part of mainstream culture. While there is a substantive body of literature addressing substance use in club settings, the world of music festivals is underexplored. The research aims to fill this gap by analysing patterns of drug use and implementation of harm reduction measures among Polish and Hungarian women at music festivals. This explorative inquiry used an online questionnaire, which was shared via social media channels. The data collection lasted for one month during the summer of 2017.

The study found that over 95% (N=510) of women use psychoactive substances at festivals. The most popular drugs are alcohol and cannabis, and the least popular cocaine and psilocybin. The majority of women declare moderate use of alcohol and light to moderate use of cannabis. One-fifth of the respondents report a moderately heavy use of 3,4-methylenedioxymethamphetamine and 8% heavy use of amphetamine. There are numerous positive weak relationships between the intensity of use of various substances. Increased use of drugs is also related to increased frequency of combining them. Low prevalence of illicit drugs testing is observed. There seems to be a negative correlation between the intensity of substance use and the adoption of harm reduction measures. The results have high practical relevance primarily for harm reduction and medical services. Especially cases of moderately heavy and heavy use should be of interest, even more so given that combining substances seems to be prevalent. The data suggest that we can distinguish between two groups: one aware and implementing various measures of harm reduction and second not adopting any of them. There is a need for more widespread drug education and harm reduction promotion, which should be implemented in a favourable legal and policy environment.

Classical definitions of motivation typically involve two main components: direction and activation. Motivated behavior is directed toward or away from particular stimuli (i.e., appetitive and aversive motivation). Furthermore, activational aspects of motivation refer to the observation that motivated behavior is characterized by substantial activity, vigor, persistence, and exertion of effort in both the initiation and maintenance of behavior. Although separate neural systems direct organisms toward distinct motivational stimuli (e.g., food, water, sex), there appears to be a common circuitry regulating behavioral activation and the exertion of effort. Mesolimbic dopamine is one of the brain systems mediating activational aspects of motivation and exertion of effort. This system integrates aspects of motivation and motor control functions involved in the instigation of action. Research on the neurobiology of effort has contributed to our understanding of the pathophysiology of neurological and psychiatric disorders that are characterized by motivational dysfunction.